ADC Best Practices: Safe Delivery, Dosage, and Monitoring Strategies

When it comes to treating cancer, antibody-drug conjugates, a type of targeted cancer therapy that combines a monoclonal antibody with a potent cytotoxic drug. Also known as ADCs, they deliver chemotherapy directly to cancer cells while sparing healthy tissue—making them one of the most promising advances in oncology in the last decade. But using them right matters. A wrong dose, a skipped check, or a missed side effect can turn a life-saving treatment into a dangerous one.

ADC best practices start with understanding how these drugs work. The antibody finds the cancer cell, binds to it, and then releases the poison inside. That sounds simple, but it’s fragile. If the linker breaks too early, the drug hits healthy cells and causes toxicity. If it doesn’t break at all, the cancer cell survives. That’s why monitoring for side effects like low blood counts, liver issues, or nerve damage isn’t optional—it’s routine. Nurses and pharmacists need to track patient weight, lab values, and infusion reactions closely. And it’s not just about the drug itself. Things like IV line compatibility, storage temperature, and mixing protocols can make or break the treatment.

Patients on ADCs often need extra support. Many of these drugs cause fatigue, nausea, or low platelets. Some, like enfortumab vedotin or trastuzumab deruxtecan, carry risks of lung inflammation or severe skin reactions. That’s why knowing when to pause treatment, when to call the doctor, and how to adjust doses based on lab results is part of the job. It’s not just oncologists doing this—it’s pharmacists checking interactions, nurses watching infusion rates, and caregivers spotting early signs of trouble. The best outcomes come from teams that communicate, not just from the most powerful drug.

There’s also the issue of access and cost. ADCs are expensive. Patients might need prior authorizations, financial aid, or alternative options if they can’t tolerate one. Knowing which generics are coming, which biosimilars are in trials, and how to switch safely between brands is part of the bigger picture. And while research moves fast, the core rules haven’t changed: verify the right drug, right dose, right patient, right time. Every step counts.

Below, you’ll find real-world guides on avoiding errors, managing side effects, tracking patient responses, and handling drug interactions—everything you need to use ADCs safely and effectively. These aren’t theory pieces. They’re checklists, comparisons, and step-by-step protocols written by people who do this every day.